New HHS Regulation Poses Threat to Women's Health

September 25, 2008

Washington, DC -- According to The American College of Obstetricians and Gynecologists (ACOG), a new regulation proposed by the Department of Health and Human Services (HHS) could limit women's access to appropriate, complete, and accurate reproductive health information and services and seriously jeopardize the doctor-patient relationship.

ACOG supports a reasonable balance between a physician's right to his or her moral or religious beliefs and a patient's right to needed health care, including reproductive health information and services. Current law, dating back 30 years, protects individuals who refuse to provide abortions and sterilizations because of objections based on religious or moral beliefs.

On August 26, 2008, HHS released a proposed regulation, with a stated intent of educating health providers about and enforcing these laws. This regulation extends the conscience protection well beyond physicians and others directly involved in patient care—the personal beliefs of pharmacists, schedulers, even volunteers and custodians could influence the information patients receive or stop patient care. And this regulation does not make any exceptions for cases in which a patient's need for emergency medical care might override an individual provider's objection.

Patients expect their doctors to give them full and honest answers to their health questions. However, this HHS regulation does not require health care professionals to disclose their personal objections to patients.

This proposal, which would apply to all institutions and physicians receiving federal funding for health services or research, is riddled with important unanswered questions. The following issues must be addressed, fully and to the satisfaction of the medical community, before this regulation proceeds any further:

  • Would employers retain rights, guaranteed under Title VII of the Civil Rights Act, to set reasonable limits on their employees' exercise of religion in the workplace?
  • What is an employer's recourse under this proposal if an employee is consistently unwilling to perform his or her job due to moral objections?
  • How does this proposal guarantee that patients would know in advance any religious or moral boundaries a provider has that might limit their care options?
  • How does the proposal reconcile the requirements of Title X Family Planning and Medicaid, which require providers to give their patients nondirective counseling?
  • What would the effect of this proposal be on state laws that require employers who offer prescription drug coverage to also cover contraceptives; require emergency rooms to offer emergency contraception to rape victims; and require pharmacies to fill prescriptions for birth control and emergency contraception?
  • How does the proposal guarantee that patients' emergency medical needs would be met?

Moreover, ACOG vehemently takes issue with HHS Secretary Leavitt's justification for this new regulation. Secretary Leavitt is wrong in citing that ACOG requires its ob-gyn members to perform abortions, and he is wrong in claiming that the American Board of Obstetrics and Gynecology (ABOG), the organization that oversees board certification, requires an ob-gyn to perform abortions in order to be certified.

First, ACOG recognizes that the issue of support of or opposition to abortion is a matter of profound moral conviction to its members and, therefore, respects the need and responsibility of its members to determine their individual positions based on personal values or beliefs.

As for the document in question, ACOG affirms that while an individual physician is under no obligation to perform a procedure that conflicts with his or her conscience, neither should an individual physician's conscientious objection create a barrier to a patient's access to reproductive health care. Likewise, institutions and organizations should, to the best of their abilities, ensure nondiscriminatory access to all professional services while minimizing the need for practitioners to act in opposition to their deeply held beliefs.

Second, ABOG has repeatedly stated that refusal to perform or refer for abortion is not a consideration for initial certification or maintenance of physician board certification. Not only is it grossly untrue, but it is disingenuous of Secretary Leavitt to continue making the assertion that physicians risk losing board certification. Furthermore, ABOG has challenged Secretary Leavitt to provide any evidence of discrimination that he alluded to in a news release last month. To date, no proof to support his accusations has been provided.

The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.